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L. Fine
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OA 11 - Reducing Burden: Patient-Centered Care (ID 682)
- Event: WCLC 2017
- Type: Oral
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:Beth Ivimey, E. Bernicker
- Coordinates: 10/18/2017, 11:00 - 12:30, Room 313 + 314
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OA 11.07 - Enhancing Lung Cancer (LC) Care in the Community Setting Through a Patient Advocacy 'Centers of Excellence' (COE) Program (ID 10423)
12:05 - 12:15 | Author(s): L. Fine
- Abstract
- Presentation
Background:
The Addario Lung Cancer Foundation’s community hospital COE Program seeks to improve LC outcomes by catalyzing the dissemination of coordinated, evidence-based multidisciplinary care incorporating institutional performance benchmarks across the LC care continuum. The COE program is a network of community-level institutions committed to objectively-measured quality improvement through annual cycles of data collection, comparative analysis and feedback. We analyzed 2016 benchmarks, comparing COE and non-COE programs.
Method:
The annual COE Impact Survey instrument includes an 81-item questionnaire administered by ZoomRx, an independent survey company. Respondents were key institutional representatives of COE- and community-level non-COE institutions. The survey measured the care continuum from screening to end-of-life care. Patient- and institutional-level data for 2016 were analyzed.
Result:
Cohort- 15 COE v 15 non-COE, mean number of annual patients per site 264 v 279; % stage III/IV patients 62 v 74; Medicare-enrolled patients, 54% v 40%; patients 61-80 years 61% v 46%; % patients who encountered financial difficulty in 2016, 42% v 34%. Institutional screening/nodule management programs: 71% of COE v 60% of non-COE programs had a low-dose CT (LDCT) screening program; 86% v 80% used a standard protocol to follow patients with suspicious nodules; 35% v 28% LDCT patients were requested to follow up on suspicious findings; 76% v 67% patients actually followed up. Diagnostic biopsy of LC was by minimally invasive endobronchial approaches in 47% v 15%. Programmatic management of patients with stage III/IV disease: 75% v 49% of patients with stage III/IV disease were reviewed at a Tumor Board and 74% v 62% had a palliative care discussion. Molecular testing was used in 51% v 81%. In patients undergoing molecular testing, institutional use of blood-based ‘liquid biopsies’ was 86% v 18% and next generation sequencing of tissue 67% v 58%. Clinical trials enrollment rates were 20% v 13%, but 18% v 31% of patients were not screened for clinical trials. In weighting factors driving treatment selection on a 100-point relative scale, COE programs weighted ‘quality of life’ (39% v 26%) and ‘patient expense’ (22% v 11%) more than non-COE programs. Non-COE programs weighted ‘product attributes’ (efficacy and safety) 48% (v 14% in COE) more.
Conclusion:
Differences exist in the approach to LC care between COE and non-COE programs. Future iterations of the COE Impact Survey will enable a data-driven approach to disseminating high quality LC care at community-level institutions, where the majority of patients seek care for lung cancer.
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P3.11 - Patient Advocacy (ID 727)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Patient Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.11-003 - Addario Lung Cancer Foundation Patient Education Handbooks Fill a Health Literacy Void for Patients and Nurse Navigators (ID 10444)
09:30 - 09:30 | Author(s): L. Fine
- Abstract
Background:
A lung cancer diagnosis is devastating and patients are often left in shock and seeking trusted resources. The Addario Lung Cancer Foundation (ALCF) provides patient education and support resources, including the patient education handbook. The handbook is a comprehensive resource on lung cancer presented in an easy-to-navigate format, written for the general public, produced in multiple languages and updated to keep pace with emerging advancements. Previous studies have shown that health literacy is correlated with patient engagement and outcomes. The handbook fills a void for patients by providing physician-vetted information on all aspects of lung cancer diagnosis and treatment options.
Method:
Two studies were conducted to assess the value of the handbook to patients and nurse navigators. The first study was a qualitative market research study that included a total of 26 patient interviews, conducted by an independent market research firm in a blinded format. The second study was the COE Impact Study which assessed the usage of ALCF resources by 15 Centers of Excellence (COE) members (a network of community hospitals) through an online survey format.
Result:
Overall, patients had positive ratings for all ALCF resources and rated the handbook highest on a 1-5 point scale system (4.4) among the resources. Patients commented that the handbook is a “one-stop-shop” for everything they need to know about a lung cancer diagnosis. Patients noted it would be most valuable to have at the time of diagnosis but that it can help at any point in their patient journey. It delivers information in a straightforward way, mapping out treatment options and next steps and empowering patients to help them manage side effects and related lifestyle issues. Nurse navigators also rated the handbook highest among ALCF patient resources and many make the handbook part of the diagnosis conversation with each patient.
Conclusion:
The patient education handbook is a valuable tool for patients and nurse navigators, especially at diagnosis when the need for trusted information is greatest. Opportunities exist to continuously improve the patient education handbook including, reformatting it to be modular, coaching patients on how to use the information to dialog with their physicians and training nurse navigators on how to use the book when they first become a COE. ALCF hopes to reach and empower as many lung cancer patients as possible with valuable and accessible information that will guide their treatment options.
